Fractional C02 Laser skin treatments

Fractional C02 laser skin resurfacing appears to achieve skin improvements that can get close to conventional ablative laser skin resurfacing but with fewer potential side effects and little downtime.

The process of directing a light source to target a selected area of the skin to damage it is technically known as “selective photothermolysis”; where “thermolysis” refers to ‘decomposition by heat’ and “photo” refers to ‘light’. Unlike with selective photothermolysis, where the whole of the selected target area is damaged; “Fractional Photothermolysis” seeks to only damage certain zones, (producing tiny dot-like treated areas on the skin), leaving the other zones within it perfectly intact; hence only causing fractional damage. This allows the skin to heal much faster than if the whole area was treated.

What can Fractional C02 Laser treat?

Fractional laser is used to successfully treat skin rejuvenation/resurfacing, which includes; the reduction and possible removal of fine lines and wrinkles, crow’s feet, improvement of deeper wrinkles, acne scarring, repair of sun damaged skin on the face, neck, shoulders and hands, the reduction of age spots and blemishes, acne scars and hyperpigmentation (areas of darker pigment or brown patches in the skin).

What happens during a Fractional Laser Skin Resurfacing treatment?

Careful discussions regarding your reasons for wanting treatment are very important before you begin the treatment. You must also make sure that this treatment can deliver what you want and how you would like to look afterwards.

A medical history will also be taken to make sure that there are no reasons why you shouldn’t undertake treatment. You may be asked to read detailed information and sign a consent form which means that you have understood the potential benefits and risks associated with the procedure.

Photographs will be taken for a “before and after” comparison at a later date.


The skin is first cleansed and a topical local anaesthesia may also be applied to increase patient comfort during the procedure, the handpiece also has a built in cooling mechanism.

The laser treatment head is then passed over the surface of the treatment area in a series of horizontal and vertical overlapping passes, until an erythema or mild redness is noted in the skin by the practitioner.

The anaesthetic are washed off immediately after treatment.

A typical treatment of the face will take approximately 20-25 minutes.

Repeat Procedures

Unlike with ablative laser resurfacing, where one treatment is usually enough; multiple treatment sessions are often required with fractional resurfacing to obtain optimal results, although as the machines have developed over the years many are now claiming a single treatment session only.

The number of treatment sessions required depends upon the individual patient and the condition undergoing treatment; your practitioner will be able to create an appropriate treatment regime for you.

How long will it take to recover from Fractional Laser Skin Resurfacing?

Most patients will be able to return to work immediately following this type of procedure.

Due to the way the laser treats the skin, it remains relatively strong, therefore any redness can be camouflaged with make-up straight away without any ill effects; and men are also able to shave almost immediately after the treatment.

What are the risks and potential complications from Fractional Laser Skin Resurfacing treatment?

Fractional photothermolysis or laser skin resurfacing offers speedy healing and minimal to no downtime.

Depending on the area of your body treated and the type of device used, the procedure is said to be well tolerated; feeling like a mild prickling or burning sensation, or like elastic bands flicking on the skin. However, your practitioner may apply a topical anaesthetic to your skin prior to treatment to reduce any pain and discomfort, and offer you a chilled air device to hold over the treatment area yourself.

For several hours afterwards the skin will feel tight and have the appearance of a “sunburned” look. The skin will continue to look “pinkish” for 2 – 7 days (depending on the device used) and any swelling, which should be minimal, usually disappears after 1 – 3 days.

Generally, as the skin heals itself, you will find mild to moderate skin flaking, which may last for up to 2 weeks.

Side effects or risks are minimal with this type of treatment and typically involve swelling and redness. There is a very limited risk of infection or scarring, with no oozing or crusting of the skin.

Compared to laser resurfacing, there is a reduced risk of hyper- or hypo- pigmentation (areas of darker or lighter skin colour) with fractional photothermolysis. This is due to the fact that areas of healthy tissue are kept intact between the treated areas, unlike with ablative lasers, meaning that lasting pigment change does not occur.

What should you do after a Fractional Laser Skin Resurfacing treatment?

It is very important that you follow the advice of your practitioner carefully after any light treatment to help make the procedure as successful as possible and to reduce the risk of complications.

Post – treatment advice may include:

  • Women can camouflage skin redness with make-up straight away if desired.
  • Apply a hypoallergenic moisturiser which can help mask any bronzing and skin flaking symptoms.
  • Avoid creams with active ingredients such as AHAs or Retinoids which irritate the skin and could impede the healing process.
  • Do not sleep on the treated area, to help avoid any swelling; e.g., sleep on your back rather than your side if your face has been treated.
  • Cool compresses (not ice packs) or cooling gels such as aloe vera can be applied to the treated area if required.
  • Avoid sun exposure during treatment and healing phases and/or wear sunscreens with an SPF of 30+ which contain zinc oxide.

Who should not have a Fractional Laser Skin Resurfacing treatment?

Patients generally not suitable for any form of light treatment are those who have a history of skin sensitivity to light or scarring problems, an active herpes (cold sores) infection or other skin infections such as impetigo at the site to be treated.

Patients who have used isotretinoin in the last year would also not be suitable candidates.

Depending on the type of fractional laser device used there may be issues of safety for people with some darker skin types, particularly Fitzpatrick skin types IV, V and VI; Hispanic, Latin, Asian, Indian, Middle Eastern and both lighter and darker toned black skin. Always seek advice about your skin type from an experienced laser professional.

Although there is no clinical evidence that this treatment is harmful for pregnant or nursing women, you would generally be advised to wait until after you have given birth and finished breast feeding before embarking upon a course of treatment.

For further information or to arrange a consultation, call Dr Joney De Souza Aesthetic Clinic at 98 Crawford Street on 020 7043 0748 or email

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